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0067 OAK STREET - Health
67 Oak Street Cotuit. P " ` A = 018 128 ✓ 0 . - .. rw r•:-r,.« R �. � a ;s a _ py - ..�r .a. ra.. "•-✓i' "^'b s: '"$.-;` No. Fee J L/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for MigPogar *pgtem Congtructiou Permit Application for a Permit to Construct( ) Repair( ) Upgrade Abandon O ❑ Complete System Individual Components Location Address or Lot No. 67 o AK-S T C-O`rU C T_KI Owner's Name,Address,and Tel.No. PAT AtCK,M ilviHA4 Assessor's Map/Parcel ®2b6 7 Installer's Name,Address,and Tel.No.0,1A0 E 3 (yl l�M Designer's Name,Address and Tel.No. &A E S'Av v ttc t°1 f-AA. `c oeue S Type of Building- Dwelling No.of Bedrooms `7 Lot Size 9 6O40-- sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 41C/6 gpd Design flow provided y sG j gpd Plan Date 7 r /(L? Number of sheets Revision Date Title PtoPof" o:47r i c- ��.T_ 1Y1 M PIA-lu Size of Septic Tank c Type of S.A.S. G9 eApA}'lli/ UQP)y Gr Description of Soil 5:—6�_ _ AT"C016,0 P IAYV Nature of Repairs or Alterations(Answer when applicable) C,1e-- Date last inspected: Agreement: r � The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. • 0 Signed Date 7 JRJ6 t Application Approved by V Date i a Application Disapproved by. Date for the following reasons Permit No. a oro i OU40 Date Issued, 3 a 1 No. �, 5 0 y, rt Fee - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN-OF BARNSTABLE, MASSACHUSETTS IYes Z(ppYication for Dioonl &p.tem,Construction Permit `( Application for a Permit o Construct O Repair O Upgrade(4j_'**Xbandcm O ❑ Complete System U Individual Components Location Address or Lot No. 67 0.49 S'T. CoTv 1 T-K1 4 Owner's Name,Address„and Tel.No. l t .._ - PA•7-Q t t K 1,ej.j1V114 4 q Assessor's Map/Parcel .' Z `A- G 3 V�6i D A 16 N,-A O Z G-+1�2110 IV162 IAA 7 J—b477-s"3�� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 4/3-<.aT 6A 5,A tv i-t i c t l r-A A. E•xGJ Iv66)21 nY, ►c%i2 t� S Type of Building: Dwelling No.of Bedrooms Lot Size Clu004�-- sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ~" ^M Design Flow(min.required) y 196 gpd Design flow provided sG . gpd Plan Date 719/Q 9 Number of sheets, Z Revision Date Title P►2o00r6b S-4-PTI 5- S'Y S71G^A /S1 1� P/A-N Size of Septic Tank Type of S.A.S. /-j1 C74 C f P,4L/ /f 13. /0 D? f Description of Soil 5,6-E AII-A C01EP r0/Arm r � Nature of Repairs or Alterations(Answer when applicable) Kl C121;4_7 Cjj 4GL 64 00 Date last inspected: , Agreement: i; The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the''system in operation until a Certificate of f Compliance has been issued by this Board of Health. %� `c nn i Signed 1�-Yle a"1 Date VIV6 Application Approved by 1, Date/77b 3 p Gj Application Disapproved by: Date for the following reasons , fj Permit No. rjo Date Issued // G THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded (4_ � Abandoned( )by /n�0j A e r r`�rr• at C, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. )O'tl )06 dated 7//3/a`j Installer S� 1,e'P6-f1Pt.i i'1_ Designer #bedrooms 7 Approved design fl6 Lw y o gpd The issuance of t"is pe it shall not be construed as a guarantee that the system wil fu.r��t/t'on as dens(** d. Date � �+ Inspector N V,1, No. Fee 1� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Digogar *pgtem Construction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( Abandon ( ) System located at 6, 2 6 A(4— PT Ca 7-&t 1 A� r4 . and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. l Provided: Const ctio •must be completed within three years of the date of this perm' . 4 Date 0 PP Y Approved b 1 r , Town of Barnstable Regulatory Services s - Thomas F. Geiler,-Director Public Health Division Thomas McKean,Director MOM*Street,Hyannis,MA!02601 Office: 508.8624644 Fax; 5087790-6304 Installer&Des-inner Certif,cation Form Date: Sewage Permit# i Assessor's Ma p\Parcel $ 2 Fe.ky- Mr- be w signer: 1=h5 n2e,rt r�g �'�YtifS it C Installer: Address;. l2 11�, Cross t e l d Address: 'inea -d alQ M Q • Z, 3-7 was issued a permit to install a � (date) (installer) septic system:at E? Oc L� S t based on a design drawn by (address) �e�-✓ C1c G w1--e,e dated 1 (designer) i certify that the septic system referenced.above'was installed substantially.according to the design, Which may include minor approved changes such as lateral relocad of the distnbut-on box and/or septic tank: I certify that the septic system referenced.above was installed with major changes (i.e, greater,than 10',lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State* Local Regulations. Plan revision or certified as-:built by designer to follow. 4�1 PETER T. GN ,sue_ (140% T's Signature) o Nt c E N TE E -a c' CIVIL No.35109 O Q F`SS10 N A L ���% * er's Signature) e lm ) (Affix Designers Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DMSION GERTIRICATE OF COh PL1A1+� E wILL NOT BE LSSITED .NTIL BOTH THYS 'FORM AND AS-BUILT CARD ARE RECBTVED:$Y THE BARNSTABLE PUBLIC HEALTH DIVISION THANK YOU Q:Health/SeOVDesigwr Certification Form 3-26-04.doc V TOWN OF BARNSTABLE �I�OCATION ��Q �'� SEWAGE# 106 1- �2 D . VILLAGE CQ:rCl G T ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. C *3 M&M kq as 4a -,q 7j SEPTIC TANK CAPACITY Z6W _ LEACHING FACILITY:(type) 610, 'F rVY0 0-0) (size) `Lf5U!Y k,5-1 NO.OF BEDROOMS OWNER 0 lG Ant PERMIT DATE: 7h log COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Waftr Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY WN � � � � � f W N � S W �.. R, r � O � W „C we � � N � .� _ � N , � -,.� ''9� z i11� , � to - � (� tit �' 1 t� . �O . O .�. � .� ,,. .�;rt_ '; TOWN OF BARNSTABLE 07 ,.00ATIDN �� u �'(�'�. �E# EA5P �`JILLAGE� ASSESSOR'S MAP&PARCEL i NAME&PHONE NO. �01 K SEPTIC TANK CAPACITY /000 LEACHING FACILITY: (type) `207- (size) cttAl NO.OF BEDROOMS OWNER ffji TVN fYs�Qc1 / PERMIT DATE: COQPttd=F—DATE: t_o OCO Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Oak street Water a Service 4 III 10, 5 Town of Barnstable P# 7 Department of Regulatory Services , Pubhc Health Division Hate .2 0 +alg. �� V 200 Main Street,Hyannis MA 02601 -r r Date Scheduled l (J ` t'�� Time Fee Pd. l w Soil Suitability Assessment for Sewage Disposal Perform edVBy MC �✓t�--�2 `` Witnessed By: vi yore S LOCATION&GENERAL INFORMATION Locadon.Address. ,(- t�0. Owner' Name Sr��- �c71 CCs }— Address GLe''1Gta�� 6�asa,1 Mq . 20 Assessors Map/Parcel: 6 l Engineer's Name NEWCONSTRUCTION REPAIR+ Telephone# 76f5-737 5 1 Land Use Pes a 'r Slopes(%) 2"� }��' Surface Stones C. Distances,fi+om: Open Water Body act ft Possible Wet Area. 3{,V ft Drinking Water Well ISM ft .r Drainage Way. N ft Property Line ft .Other` ft SKETCH:•(street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlandsn proximity to holes) All- Parent material(geologic) aG ^ I �iJ t'uuc�S Depth to Bedrock 1. Depth to Groundwater. Standing Water in Hole: f!3 t t i Z Weeping from Pit Face Se4( ."Q Estimated Seasonal High Groundwater DETERMINATION FQR.SEASONAL HIGH WATER TABLE Method Used: 6ya-e cod co M ah,S S+C1`--. Depth Observed standing in obs,hole: _ �-3' In, Depth to s011 mottles: In. Depth to weeping from side of obs.hole: 1 �� min, Groundwater Adjustment ft. index.Well.# M%LAJ Reading Date:,�j,z� Index Well level Adf,factor.,�,,1,� Act{.Clroundwater Level , e PERCOLATION TEST bete , Thne Observation Hole#. Time at9" Depth of Pero � 3o/Y'Z. {� �{Z _ Time at6". Start Pre-soak Time® ~' 2'P . k kkO v\, 'rime(9"•6") End Pre-soak iRt+,n U� ►ace.� �!J�Q.j Rate Mia/Inch -S Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) . Original: Public Health Division Observation Hole Data To Be Completed on Back----------- * *If percolation test is to be.conducted within 100' of wetland,you must first notify the, Barnstable Conservation Division at least one(1)week prior to beginning. QASEPTICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# i Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure;Stones;Boulders: Consisteftcy. vl DEEP OBSERVATION HOLE LOG Hole# 2-- Depth from Soil Horizon . Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure;Stones,Boulders. Consistency.% ra D A . to (L'I/ eo sib c -ice DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color- _ Soil Other Surface(in.) (USDA) (Munsell) Mottling ,••(Structure;;Stones;Boulders. Consistency. p— 5� ti6y/2_. o . DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil they Surface(in.) (USDA) (Munsell)' _ Mottling (Structure,Stones,Boulders. ni d l4 i_ 1. Ph s M S 2� U Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes _ Within 500 yearboundary No X' Yes„_T Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout,the area proposed for the soil absorption system? __) If not,what is the depth of naturally occurring pervious material? Certification I'certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consrsteritwith . the required tr ' ing,expertise and experience described in10 CMR 15.017. Date Signature Q:\SEPTICVERCFORKDOC Feb '27 2007 1 : 23PM PATRICK OCONNELL 641D S4 084281613 p. 2 y COMMONWEALTH OF MMSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE S OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION .Property Address: 67 Oak Street Cotuit MA 02635 Owner's Name: Meredith Brodeur Owner's Address: 532 Seibert Ave. Destin FL 32541 Date of Inspection: June 6,2006 Job#06-228 Name of Inspector: PATRICK M.O'CONNELL Company Name: SEPTIC INSPECTION SERVICES CO. Mailing Address: 189 CAMMETT ROAD MARSTONS MILLS MA 02649 Telephone Number: 509-428-1779 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a Dttu►pf� approved system Inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: �� / YZ _X_ Passes Conditionally Passes AT ^K Needs Further Evaluat' n by the l.oc Approving Authority a o - Fails 0 d � �y Inspectors Si nature: � Date: 6113/06 �., � F,1 : P g i� The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments: Leaching pit empty at time of inspection,Tank is not in need of pumping,. ****This report only describes conditions at the time of inspection and under the conditions of use at that time,This inspection does not address how the system will perform in the future under the some or different conditions of use. Feb 27 2007 1 : 23PM PATRICK OCONNELL 5084281613 p. 3 Page 2 of l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 67 Oak Street,Cotult Owner: Meredith Brodeur Date of Inspection: June 13,2006 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _X have t fun an 't described 'n 10 R X i o found information which indicates that an of the failure criteria desc b d� 3 CM Y Y 15.303 or in 310 CMR 15,304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfrltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipes)are replaced obstruction is removed ND explain: Feb 27 2007 1 : 23PM PATRICK OCONNELL 5084281613 p. 4 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 67 Oak Street,Cotuit Owner. Meredith Brodeur Date of Inspection: June 13,2006 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment I. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning In a manner that protects the public health,safety and environment: _ Tbo system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone i of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**.Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Feb 27 2007 1 : 26PM PRTRICK OCONNELL 5084281613 p. 5 Page 4 of 1 l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 D. System Failure Criteria applicable to all systems: You must indicate`des"or"no"to each of the following for all inspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool — X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than_day flow _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _ xX Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. x Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.(This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.) (Yes/No)The system Rik.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. barge Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 1S,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The.owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Feb 27 2007 1 : 26PM PATRICK OCONNELL 5084281613 p. 6 Pages of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 69 Oak Street,Cotuit ' Owner: Meredith Brodeur Date of Inspection: June I3,2006 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No _ _X_ Pumping information was provided by the owner,occupant,or Board of Health _ _X_ Were any of the system components pumped out in the previous two weeks? X_ Has the system received normal flows in the previous two week period ? X_ Have large volumes of water been introduced to the system recently or as part of this inspection? _ _X Were as built plans of the system obtained and examined?(If they were not available note as N/A) — _X_ Was the facility or dwelling inspected for signs of sewage back up? A X _ Was the site inspected for signs of break out? X Were all system components, _ _ ____ y p ts,excluding the SAS,located on site . X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions, depth of liquid,depth of sludge and depth of scum? X_ Was the facility owner(and occupants if different from owner)provided with information'on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no _ _X Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)J Feb 27 2007 1 : 27PM PRTRICK OCONNELL 5084281613 p. 7 Page 6ofII OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):330 Number of current residents:0 Does residence have a garbage grinder(yes or no):No Is laundry on a separate sewage system(yes or no):No [if yes separate inspection required) Laundry system inspected(yes or no): Seasonal use:(yes or no): Yes Water meter readings,if available(last 2 years usage(gpd)): two years total: 193,000 gal.=264 gpd. Sump pump(yes or no); No Last date of occupancy: unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR I 5.203): gpd Basis of design flow(seats/persons/sq$,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records: None Source of information: Was system pumped as part of the inspection(yes or no): No Ifyes,volume pumped:____gal Ions—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank ,Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: 1978 ' Were sewage odors detected when arriving at the site(yes or no): No Feb 27 2007 1 : 28PM PATRICK OCONNELL 5084281613 p. 8 Page 7 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 69 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 BUILDING SEWER:XX (locate on site plan) Depth below grade: I Materials of construction:_cast iron X 40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting,evidence of leakage,etc.): SEPTIC TANK: XX (locate on site plan) Depth below grade: I' Material of construction:_X concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:_ is age confirmed by a Certificate of Compliance(yes or no):^(attach a copy of certificate) Dimensions:B.S'long x 5.2'wide—1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle:29" Scum thickness: 2" Distance from top of scum to top of outlet tee or battle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 12" How were dimensions determined: STICK WITH HINGE FLAP. Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): tees are intact and clear,liquid level at bottom of outlet invert Tank is no tin need of pumping at this time. GREASE TRAP: No (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal fiberglass polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or battle: Distance from bottom of scum to bottom of outlet tee or battle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or battle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Feb 27 2007 1 : 29PM PRTRICK OCONNELL 5084281613 p. 9 Page 8 of 1 l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 Oak Street,Cotuit Owner; Meredith Brodeur Date of Inspection: June 13,2006 TIGHT or HOLDING TANK: No (tank must be pumped at time of inspection) (locate on site plan) Depth below grade: Material of construction; concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: XX (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: 0" Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc,): Box is located under deck steps and was video Inspected.Liould level is at bottom of outlet invert,no solids or hieh stains were observed. PUMP CHAMBER: No (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Feb 27 2007 1 : 30PM PATRICK OCOMNELL 5084281613 p. 10 Page 9 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: Jane 13,2006 SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required) If SAS not located explain why: Type _X leaching pits,number: One 6x6 pit. leaching chambers,number: leaching galleries,number: leaching trenches,number,length: Icaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): Leaching Pit was emote at time of lnsnec 'on sidewall stains in Pit indicate Pit has never held more than 12"of water. CESSPOOLS: No (cesspool must be pumped as part of inspection) (locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: No (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Feb 27 2007 1 : 30PM PATRICK OCONNELL 5084281613 p. 11 Page 10 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within I00 feet.Locate where public water supply enters the building. Oak Street Water Service 10 . 15 41 58 Feb 27 2007 1 : 32PM PRTRICK OCONNELL 5084281613 p. 12 Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water: More than 15 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting hole within property/observation thrn 150 feet of SAS Checked with local Board of Health-explain: ) Checked with local excavators,installers-(attach documentation) _X_Accessed USGS database-explain: USGS topo map and town GIS You most describe how you established the high ground water elevation: Town groundwater contour map shows water below el.5 and topo map shows property at or above el.20. i COMMONWEALTH OF MASSACHUSETTS FFAIRS EXECUTIVE OFFICE OF ENVIRONMI'N'PRO PROTECTION DEPARTMENT OF ENVIRONMENTAL R OW Y TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY STEM FORM ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL PART A CERTIFICATION RECEIVED 0 05- Property Address: 67 OAK ST COTUIT, MA 02635 JUL 0 8 2002 Owner's Name: SHEEHAN°; Owner's Address: KINLIN GROVER GMAC REAL ESTATE TOWN OF BARNSTABLE HEALTH DEPT. Date of Inspection: 6/17/02 Name of Inspector: (please print),! JOHN GRACI Company Name: SEPTIC INSPECTIONS Mailing Address: x ,. :P:O.BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813'FAX 508-564-7270 CERTIFICATION STATEMENT ion performed based on my training and was sal system at this address and that the information reported below certify is I fy that I have personally inspected the sewage dispo true,accurate and complete as of the time of the inspection.The inspection ;y stems. I am a DEP approved system experience in the proper function and.mainfenance of on site sewage disposal.. inspector pursuant to Section 151346 of Title 5(310 CMR 15.000). The system: X Passes s _ Conditionally ses _ Needs Furth valuation by the Local Approving Authority Fails Date: 6/17/02 Inspector's Signature: within The system inspector shall submit copy of this inspection report to the Approving Authority(Board of Health or DEP) T ydesignd or realer,the 30 days of completing this inspect on. If h t system report s the appropriate regional e of the DER The original should be inspector and the system owner shad subs p approving authority. sent to the system owner and copies sent to the buyer, if applicable,and the app' g Notes and Comments ' SYST EM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE: ' ' ' **** report only deserilieslconditions at the time of inspection and nder'the same lorl'different conditions lls of use at that of use's This repo y inspection does not address;bow the system will perform in the future u of 1� innn . Page 2 of l 1. ` OFFICIAL INSPECT19N FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE,.SEWAGE DISPOSAL SYSTEM iNSPECTION FORM PART A CERTIFICATION (continued) Property Address: 67 OAK ST COTUIT,MA 02635 Owner: SHEEHAN Date of Inspection: 6/17/02 Inspection Summary: Check A,B,C,D or,E/ALWAYS complete all of Secti-.-,ii. D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPEC' ION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. B. System Conditionally Passes. _ One or more system componenif`s'as'described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement;or repair,as approved by the Board of Health, will pass. .r Answer yes, no or not determined(Y,N;Ta;`D in the for the following state If"not determined"please explain. n/a The septic tank is metal and overt20�ears old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than20 years'old is'available. ND explain: n/a n/a Observation of sewage backup or Break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced obsh4uct1on is'removed _ distribution box is leveled or replaced ND explain: n/a n/a The system required pumpin�more han 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval o f the Boara4 Health): broken:,pil:e(i),are replaced _obstruction is removed ND explain: n/a �;, Page 3 of 1'1, •. is OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ' CERTIFICATION(continued) 0: Property Address: 67 OAK�S1 COTUIT, MA 02635 Owner: SHEEHAN tT " Date of Inspection: 6/17/02 C. Further Evaluation is I:ecluired,by the,Board of Health: 4-. Conditions exist which re tni�,� further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or tlie�•environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is �, . not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy 'is n SO f,et of a surface water _ Cesspool or privy is .ii i i n.50.'.kefofa bordering vegetated wetland or.a salt marsh t 2. System will fail unless Ilie Board of Health (and Public Water Suppli:;rjf any)determines that the system is fu.:; ;��� in a spanner that protects the public health,safety and environment: r _ The system has a scit:t i and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a sl' i;,ic..water'supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a s: sir ! ,:I<'and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a sc and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply I well".Methc me distance n/a "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and .s f volatile organic conip,)im(k indica3es that the well is free from pollution fil-:ri that facility and the presence of ammonia nitrogen and nitrate niii-o-en.is epual to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must this form. 3. Other: n/a It•:.. Page 4 of 11 t _ y.. kit 'c 7's 5 i OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACESEWAGE DISPOSAL SYSTEM INSPECTION FORM t, , .,- . PART A i 'r CERTIFICATION(continued) Property Address: 67 OAK ST COTUIT, MA 02635 Owner: SHEEHAN Date of Inspection: 6/17/02 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each`q the following for all-inspections: Yes No _ X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponaing of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/2 day flow _ X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped nLa. ,, ; X Any portion of the SAS,�cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspbol',dr privy is within a Zone I of a public well. _ X Any portion of a cesspool on privy is within 50 feet of a private water supply well. X Any portion of a cesspoohor privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,W..,ccliform bacteria and volatile organic compounds indicates that the well is free facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or from pollution from that less than 5 ppm, provided;that no other failure criteria are triggered. A copy of the analysis must be attached to this form.,[r,, (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system,fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. Large Systems: E. g To be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 gpd. You must indicate either"yes'%r"no";to each of the following: The following criteria apply to'large a systems in addition to the criteria above) ( g pP Y g , yes no , X the system is within 400 feefof.a,surface drinking water supply X the system is within 200,tfeet,Qf a tributary to a surface drinking water supply X the system is located in a,nitrogen'sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public watertsupply,well If you have answered"yes, Et#c any question in Section E the system is considered a significant threat,or answered "yes' in Section D above the large sysl r,rl Iri! ,I' 'I'hc Owner or Operator of Lilly I.irge�yt;lem conF;ideretl it frignificni-it Ihrent under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 j. OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 67 OAK ST COT.UIT,MA 02635 Owner: SHEEHAN Date of Inspection: 6/17/02 Check if the following have been�done... ou must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information'was-provided by the owner,occupant,or Board of Health S X Were any of the system components pumped out in the previous two weeks? _ X Has the system received no`'rmal flows in the previous two week period X Have large volumes of water,been introduced to the system recently or as part of this inspection ? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out'? X _ Were all system components,excluding the SAS, located on site'? X _ Were the septic tank manhole's uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems"`;`, The size and location of the.Soil,Absorption System (SAS)on the site has been determined based on: Yes no X _ Existing information. For example,a plan at the Board of Health. X _ Determined in the field(if any,'of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] ; t. c ', •'R 10 Page 6 of l l t i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 67 OAK ST COTUIT,MA 02635 Owner: SHEEHAN Date of Inspection: 6/17/02 -y FLOVV CONDITIONS RESIDENTIAL ' Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms,:330 y Number of current residents: n/a Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes"or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO + Seasonal use: (yes or no): NO Water meter readings, if available;(last 2 y cars.usage(gpd)): n/a Sump pump(yes or no): NO !'<l Last date of occupancy: n/a ` COMMERCIALANDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203):n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present,(yes or no): NO Non-sanitary waste discharged to the,Title 5 system(yes or no): NO Water meter readings, if available:n/a. Last date of occupancy/use: n/a - OTHER(describe): n/a ;GENERAL INFORMATION Pumping Records Source of information: n/a Was system pumped as part of the'inspection(yes or no): NO If yes,volume pumped:n/agallons--Hpw,was quantity pumped determined? n/a Reason for pumping:n/a TYPE OF SYSTEM h X Septic tank,distribution box;soil absorption system _Single cesspool Overflow cesspool ` _Privy _Shared system(yes or no)(if yes,,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ; _Tight tank Attach a copy.of�the DEP approval Other(describe): n/a Approximate age of all components,,date,installed(if known)and source of information: 1978 BY AGENT , Were sewage odors detected when arriving at the site(yes or no): NO 5 A Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUN ARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 OAK ST COTUIT,MA 02635 Owner: SHEEHAN Date of Inspection: 6/17/02 t- BUILDING SEWER(locate on site plait) i Depth below grade: 18" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER . SEPTIC TANK: X(locate on site plan) Depth below grade: 12" Material of construction: Xconcrete' met l_fiberglass_polyethylene other(explain)±i. If tank is metal list age: n/a Is age.confirmed by a Certificate of Compliance(yes of no): NO(attach a copy of certificate) Dimensions: 1000G L 8' 6 H 5' 7""W,4' Sludge depth:3" Distance from top of sludge to bottom of outlet tee or baffle: 31" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom•of outlet tee or baffle: 16" How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,.etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. {A � GREASE TRAP:_(locate on,site,plan) Depth below grade: n/a Material of construction: concrete metal,_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a t Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage;etc.): . i• n/a 7 . 1 �9 7 Page 8 of]I1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) '.i�try . �i Property Address: 67 OAK ST COTUIT,"MA 02635 Owner: SHEEHAN Date of Inspection: 6/17/02 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day ' Alarm present(yes or no): N/A Alarm level: N/A Alarm in working o►def(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a l 3 DISTRIBUTION BOX: X.(if;p(esent,must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments(note if box is level'<and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): D-BOX WAS VIDEO INSPECTED AND APPEARS TO BE STRUCTURALLY SOUND. PUMP CHAMBER:_(locate on site'plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump char,hber;bcondition of pumps and appurtenances,etc.): n/a i , r , . I ri„ . I I ; 1 t' R Page 9 of 11 N .. .. r OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 OAK ST COTUIT,MA 02635 Owner: SHEEHAN Date of Inspection: 6/17/02 r SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' I leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a *'€;- leaching trenches, number, length n/a n/a s, leaching fields, number: n/a n/a overflow cesspool, number: �•F n/a innovative/alternatives stem - n/a � .. ��� Y I < . .;r•d.-Type/name me of technol ogy: gY• .. nla Comments(note condition of soil,signs of hydraulic failure, level of ponding;damp soil,condition of vegetation,etc.): LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.SYSTEM SHOWS NO SIGNS OF FAILURE.PIT WAS EMPTY AT TIME OF INSPECTION. STAIN LINES INllICATE PIT HAS NEVER HAD MORE THAN 2' OF LIQUID IN IT.r,BOTTOM OF PIT IS AT 81.. CESSPOOLS: (cesspool must be pumped,as�part of inspection)(locate on.site plan) Number and configuration n/a` Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no):,NO Comments(note condition of soil,signs of hydraulic failure;level of ponding,condition of vegetation,etc.): n/a s, PRIVY: (locate on site plan) Materials of construction: n/a ," Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,sighs ofhydraulic failure, level of ponding,condition or vegetation,etc.): n/a Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C i w SYSTEM INFORMATION(continued) Property Address: 67 OAK ST COTUIT MA 02635 Owner: SHEEHAN Date of Inspection: 6/17/02 1, SKETCH OF SEWAGE DISPOSAL;SYSTEM Provide a sketch of the sewage disposal,system including ties to at least two permuncnt reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. a, r in Page I I of l 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUP,"I'ARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM 1 ,:SPECTION FORM PART C SYSTEM INFORMATION(conthwed) Property Address: 67 OAK ST COTUIT,MA 02635 Owner: SHEEHAN Date of Inspection: 6/17/02 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 42 feet. Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system'design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators; installers-(attach documentation) NO Accessed USGS database-explain: n/a E You must describe how you established tha high ground water elevation: HAND AUGER- 12' r d- P, p4. y `4 4 k „ 11 LOCATION SEWAGE PERMIT NO. VILLAGE cont IT INSTA LLER'S NAME & ADDRESS � p 4 'L B UIIDE R OR OWNER BOA DATE PERMIT ISSUED 'ec �� �g11 DAT E COMPLIANCE ISSUED ./____-� e� � f �� rt -� v � r '~- r.+ 97 No.. .............. Fis..... ................... THE COMMONWEALTH OF MASSACHUSETTS MA BOARD OF HEALTH PARCEL 1? „ } Appliration -for Uiapwial Workii Ton5trnrtinn Vrrniit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: •---•----------------v.................................. ........ ..Wit..:c.... ....................................................... ..................................... Location Add TsL t, or Lotto. I w •JJ A4 ---1.,�,n,w,,.�---------------=------------------------------- ----=-------------------------------------- `.:.: ....................ow .. ................ ! rl+ ........................................-•--Aa---ss-°.: .......... x+-1 ..: Installer7 Address Q Type of Building Size Lot... feet Dwelling=No. of Bedrooms.-__.__'nz'__ ___________________________Expansion Attic ( ) Garbage Grinder ( ) pa., Other—Type of Building �!-(z�--------- No. of persons--------Y-------------- Showers ( ) — Cafeteria ( ) Other fi tu.Us ------------------------------ -- w Design Flow................ -------------------gallons per person per day. Total daily flow.__.._._...._...��:0......_..._..---gallons. P4 Septic Tank—Liquid capacitv_10t*gallons Length....... Width....0r-7_-....... Diameter__-___---_____ Depth................ xDisposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below.inlet .............. Total leaching area-_-_--_-__-_______sq. ft. z Other Distribution box ( ) Dosing tank ( c . �/—3 d' 7 ~' Percolation Test Results Performed by---- ..Ll� ).d%%,E4___--_-_____ ------------ Date....l!- 4_ �_7 ------- a Test Pit No. 1-----9- ____minutes per inch Depth of Test Pit-------1Zt____-. Depth,to ground water------------------------ f� Test Pit No. 2................minutes per inch Depth of Test Pit.______-M...... Depth to ground water........................ - Ql. nO Description of Soil__-.____-_(�. S �-______________� .._lam. � - ANJ x k w -------------------- U Nature of Repairs or Alterations—Answer when applicable.__________________............................................................................ ---------------------=..................................................................................................................................---------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The dersigned further ees not to place the system in operation until a Certificate of Compliance has been issued th oard o healt . a Signed---------- --• •------- --------------...=............................. -- ................................ Date Application.Approved By-------- Date f 1` 7 7 Application Disapproved for the following reasons___________________________________________ ------ -------------- -------•--------•--•----------------------•--•---•--•------------•----.-----•------------- Date PermitNo......................................................... Issued.----.. -r- - z ' Date `y`A i" THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t � _OF: # Applirat ,nn "fur 4�ifipviial Workii Tomitrnrtinn Vanfit M Application is hereby made for a_Permit to Con'truct ( ) or Repair ( ) an Individual Sewage Disposal System at a, C� - __ •-- -•-••--•-•-•---.---•-•-••-------•-.•--••---...- ------------------------------------ - ': I;oc ,on- ess �nc� Lot`Nod I �b�` ------------------- W ne Address j --•-----------•----•--------------- "= - Installer Address ` <'U Type of Building { Size Lot.........,t_ ____Sq. feet Dwelling—No. of Bedrooms.......__.. .........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---(3"�'r____-_-•- No. of persons.._................... Showers ( ) — Cafeteria ( ) Other fixture W Design Flow.................S .................... per person peg day. Total daily flow._.____._.._....�3 0....-----------gallons. P4 Septic Tank—Liquid cahacity._��_gallons Length............... Width."_--......._.. Diameter----........._.. Depth....---.-.------ x Disposal Trench—No...................... Width--------------------- Total Length-------------------- Total leaching area....................sq. ft. ,Ah.,u Seepage Pit No.:------------------- Diameter_.:............... Depth below inlet-------------------- Total leaching area:.............._."sq. ft. Z Other Distribution box ( ) ' Dosing tank ( ��• ��,�Jd. 77 aPercolation Test Results Performed by.--. ._ _- - __ _______________ Date__-�.• _�t�_ _ -------------- a Test Pit No. I.......y---minute§per inch Depth Test rit......�z-.._.... Depth to ground water...--------............. fI, Test Pit No. 2................minutes per inch Depth of Test Pit--------l.v--- Depth to ground a " ..... water:-."."-..-_-.---._----_-.-"- _. ----- == --------•- --------------------• Descriptionof Soil----------- ----0.=�..----------�` e- ".-=r-- ? !z U : ----- ------------------------------------------------------------------------------------------------------ ----------------------------------------------- ,.. W ` UNature of Repairs or Alterations—Answer when applicable._._-•"___------_-------------------------------------------------- ........................... w r Agreement: The undersigned agrees to install the aforedescribed Individual. Sewage Disposal System in accordance with the ,provisions of Article AXI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by e oard of :ealth. ¢ Signed.................. r Date Application aApprovedi BY----- -- ----- ffi ' - I - l/,� /-x jy ------------ "' f,. • Late S Applieat'ion Disapproved°'f or the following'reasons:...::................ ......................................................................................... e .........................................•______._.......______..._...........___._......_ Date Permit No.................................................... Issued. r Date 4 THE COMMONWEALTH OF MASSACHUSETTS" . BOARD F HEA `► .- n . ...........OF.................. ............................. .... Qrrtif irate of `:k nut lianrr S I TO CERTI Tha .the I dividual Sewage Disposal System constructed or Repaiiecj� ( ) by... '= at �/ s lee 0 • a. n has been installed in accordance with the provisions of XI of The State Sanitar .Code as descr' d in the application for Disposal Works Construction Permit No..__ _..._.7S_-*k,------------- dated ._.l�"__ _..__ -................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS AI GUARANTEE THAT THE SYSTEM MILL FUNCTION SATISFACTORY. -7 DATE 1 Inspector_.... . I---•-•------ -- THE COMMONWEALTH OF MASSACHUSETTS BOARD F °,HEALTH .1 .. .. of ....:......... No. Z.71• __ f`r ...... ..... ... FEE---------•-•..................... g ii Qlan r r -onPprutit Permission is hereby granted,.,-.""____ ranted ="'_-- ---- .- - + .... .............. . .` to Consfru` ;( o R p -r ( . ) an In 'vi al Sewa Dis s ste `� .......- I at No---- v� it' - - l L - Street as shown on the application for Disposal Works Construction Pe No _.. _. ... _ ._ Dated_-. ........... - ( a rf H Ith ....................... DATE --------------- ---- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS r -y ••y I�aI L� r=Lvw = 1 Ip .c 3 = 33� G.P•t7. 330,e ISC % < 4-9C�G.P.D. USA- lc�Op 6.4L. SPC--,&L PIT - USE. loco S tlx-= / L-L AV-E-A l 5o S.F. SD •�'ro,vl leer=n= � sT=. TOTAL -I-,> J = 425 G.RTJ> 33o G Pn. c Pt—:QC &T1C-�I,I C?-,LTE Iu JMiQ' o2 ASS. rt �� TEST Tclr p7w LT Low I o00 Iuv .'A 'box 9�6 51 Inc INV. 7-AWK IDop 15•1? GA.L. 9G.Q �G.2 C,. LEAr-H ,p M� PIT .CTUt7) WAs►tED n :..� CF_CZTtF1>=LD pL.dr Fl;zoT t LE: --- 12 L-E55 uo Scn`� = _t=cnt ('! l��j b �1AT II 13oI :tJG W,Q-IC-rZ, - I Gtai2 i iF=�( T i-1AT TI-IG FoU�-I�DATtoh1 5"ci.4jQ pLikI-1 IZI=r--aRE C:.a 1-1�.6't_z5t�1 Gc�1ilC�L�(a W iTl� Yi-i` �jID� Llt-i� II N_ Abii� ( 'i 1 ,/�Ci! �=( tJ1�'Erl/tC:i ley Dt= T'N€ : i.OT D Iv c A�2 tJyTAr;l l�L A►J r rL ur.•�i= 11 3p Z �C �� t"' �J � __-- .Ali .z► 1 d� - 4- _ ��.7�T t;1�. 4� I•J Y I�.1 c REGI�, i'CED 't-1�iJG �U2vEYuiLS TI-�IIS t�t�/�I a t� I_:�oT ti;,car,EC� vI•.� �.�.1 0�T�QVILt..L_ o �LC�S�,, tt�l'yt�hJ'✓lL=l:ii' �.J�'_,/1=ti' �-'C13i_:, (:SFr-1 ji=t"�i mil-�CiA.:JLD 1 t 0 � a 4 ry V f (251 a 00 1 V f - , COMMONWEALTH OF MASSACHUSETTS JD EXECUTIVE OFFICE OF ENVIRONMENTAL�AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION UT TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 67 Oak Street Cotuit MA 02635 Owner's Name: Meredith Brodeur �z Owner's Address: 532 Seibert Ave. 9�� Destin FL 32541 Date of Inspection:June 6,2006 Job#06-228 Name of Inspector: PATRICK M.O'CONNELL Company Name: SEPTIC INSPECTION SERVICES CO. Mailing Address: 189 CAMMETT ROAD MARSTONS MILLS MA 02648 Telephone Number: 508-428-1779 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a Dtttrip�r approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ��� •• /�Igs�ii��� _X_ Passes �yG Conditionally Passes Needs Further Evaluat' n by the Loc Approving Authority o ;y Fails w CO— Inspector's Signature: Date: 6/13/06 �., �F5 iNS?���``��o The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments: Leaching pit empty at time of inspection,Tank is not in need of pumping. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _XX I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(l)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _X__ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ —X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _X Liquid depth in cesspool is less than 6"below invert or available volume is less than_day flow _ _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _X_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water-quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] _No_(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd- You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ the system is within 400 feet of a surface drinking water supply _ the system is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No _ _X Pumping information was provided by the owner,occupant,or Board of Health _ _X Were any of the system components pumped out in the previous two weeks? _X Has the system received normal flows in the previous two week period? _ _X Have large volumes of water been introduced to the system recently or as part of this inspection? _X Were as built plans of the system obtained and examined?(If they were not available note as N/A) _ _X Was the facility or dwelling inspected for signs of sewage back up? _X _ Was the site inspected for signs of break out? _X_ _ Were all system components,excluding the SAS,located on site? _X_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no _X_ Existing information.For example,a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 67 Oak Street;Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):330 Number of current residents:0 Does residence have a garbage grinder(yes or no):No Is laundry on a separate sewage system(yes or no):No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no): Yes Water meter readings,if available(last 2 years usage(gpd)): two years total: 193,000 gal.=264 gpd. Sump pump(yes or no): No Last date of occupancy: unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): jzpd Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records: None Source of information: Was system pumped as part of the inspection(yes or no): No If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: 1978 Were sewage odors detected when arriving at the site(yes or no): No Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 BUILDING SEWER:XX (locate on site plan) Depth below grade: I Materials of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: XX (locate on site plan) Depth below grade: 1' Material of construction:_X_concrete_metal_fiberglass__polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions:8.5'long x 5.2'wide—1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle:28" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 12" How were dimensions determined: STICK WITH HINGE FLAP. Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees are intact and clear,liquid level at bottom of outlet invert.Tank is no tin need of pumpine at this time. GREASE TRAP: No (locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 TIGHT or HOLDING TANK: No (tank must be pumped at time of inspection) (locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: XX (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: 0" Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): Box is located under deck steps and was video inspected Liquid level is at bottom of outlet invert,no solids or hieh stains were observed. PUMP CHAMBER: No (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required) If SAS not located explain why: Type _X_leaching pits,number: One 6x6 pit. leaching chambers,number: leaching galleries,number: leaching trenches,number, length: _leaching fields,number,dimensions: overflow cesspool,number: _innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): Leaching nit was empty at time of inspection sidewall stains in pit indicate pit has never held more than 12"of water. CESSPOOLS: No (cesspool must be pumped as part of inspection) (locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: No (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 Oak Street,Cotuit Owner: Meredith Brodeur Date of Inspection: June 13,2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. Oak Street Water Service 10 15 41 58 Page 11 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 67 Oak Street,Cot nit Owner: Meredith Brodeur Date of Inspection: June 13,2006 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water: More than 15 feet Please indicate(check)all methods used to determine the high ground water elevation: _Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: _Checked with local excavators,installers-(attach documentation) _X_Accessed USGS database-explain: USGS topo map and town GIS You must describe how you established the high ground water elevation: Town groundwater contour map shows water below el.5 and topo map shows property at or above el.20. --gg - EXISTING CONTOUR N ' 00.05 x 100.98 EXISTING SPOT GRADE , 99,07 W EXISTING WATER SERVICE 101.42 a -98 - *"G G GAS SERVICE EXISTING M /tr CB/DH/FND 0 96,7 s•oo UNDERGROUND WIRES z 96.55, k ® TEST PIT Pine Rid a Rd a / 8.0 x o BENCHMARK rn k rson 6.84 96.21 E �/ , r� �^ oa Sea St i 10 /, 7.7 95 �p (96.5 UP/143- Fp �` r :LEGEND c vA �i / .69 3° ,Ol x / Oak St 98.63 C l � .. 2 63j„ ;5.46 of e0 .• Nickerson Rd 9 M • z , 97,49 J a x 96,84/•,.� ip9615- � LOCUS MAP j �\ • x '�6.16 1 NOT TO SCALE L EXISTING LEACH PIT 97.35 O t 4 r * , 3 -EX/S71NG � '- --94 °43 600E S.F. TO BE PUMPED &, FILLED HOUSE 7 ° 04' �° s W/SAND OR REMOt/ED 9g. � � »? -PINE, AC soh To 98.56- .1:OOf ' (Assumed) 100.64F y 97. 7 / A�/p '/f� i PROPOSED \_ ;*/Y/V p / V CB DH/ ND 97.23 .-. r ek a 69 Parcel 28 Deck A0NN x 95°0 PINE 93.11 ''- Shed`., :,96,71x s�,o. DDyT1r N 96.78 i� INE Edge of Lawn „x 92.62 x 8s�• _ GENERAL NOTES: , �• 9 60 94.37 I ! _ x �/ - l " 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY-THE LOCAL ` = N x 95• / •`92:70 RS• ��/ s BOARD OF HEALTH AND THE,DESIGN ENGINEER. x''93°40' i �TP_1i� 2. ALL WORK AND'MATERIALS SHALL CONFORM TO THE REQUIREMENTS 87P 4 k 9 3 93.0 Q�/ ' OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE �, o �ji „ 'LOCAL RULES AND REGULATIONS: to Tp 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR co x 92.46 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 4J3 i a DESIGN ENGINEER. c3: / i Gorden i ��, i/ ,. (46 A,) 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING - �,• �� �i b' ^/ FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE -DESIGN x 93 84 T ENGINEER BEFORE CONSTRUCTION CONTINUES. i 5. ALL .ELEVATIONS .BASED ON ASSUMED.DATUM. 93,24 � x 95,01 +� x�_9.3.39 . ' 4 ' x 951-1.3 1 CI 9� -5 to _ 6.'THE DESIGN ENGINEER IS ,NOT RESPONSIBCE FOR THE FAILURE OF N THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF i `93.18 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. .,7. WATER„SUPPLY PROVIDED'BY PRIVATE WELL. i t tTr' W ," w , . >' �?6¢, 8. THERE ARE NO PRIVATE WELLS.WITHIN 150' OF.THE PROPOSED S.A.S. 9. ALL AREAS CLEARED' FOR CONSTRUCTION SHALL BE RESTORED AS 6 •/��" a3�9 �= AGREED UPON BY OWNER AND 'CONTRACTOR OR AS 'OTHERWISE DIRECTED BY. THE APPROVING AUTHORITIES. Benchmork set Wdy t 10. It SHALL BE THE LOCATIONTHE OF ALLP�NDERILITY OF G OUNDTHE UTILITIOESTRACTOR TO PRIOR TO BEGINNING Right cor.. bulkhead- CONSTRUCTION. EL.=97.96 (Assumed) _ 364 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL, UNSUITABLE SOILS 2�y,56 EXISTING SEPTIC TANK 1pFMA _� w `., IN-THE AREA BENEATH AND •FOR 5' ON ALL SIDES OF THE, S.A.S. AND. \�` 12.` ENGINEER IS NOT RESPONSIBLE`FOR ANY UNDOCUMENTED SEPTIC SYSTEM' (To REMAIN) ��� SSq� 106. COMPONENTS NOT SHOWN ON THE PLAN. 5 TOP OF TANK, EL.=95.26f 5 / INV(lN)=93.93f(t/ERIFY) TERRY OF A CB/DH/FND ` M WIND EXPOSURE CATAGORY: Exposure B wANN " ``� ss9c�G PROPOSED SEPTIC SYSTEM SITE PLAN No.ZONING CLASSIFICATION: RE , o •. PETER ,T. ✓ `McENTEE 67 OAK STREET, COTUIT, MA. SETBACKS: FRONT, YARD=30" o CIVIL ` SIDE YARD=15', REAR YARD=15' ,; No. 35109 Prepared for:' Patrick Minihan, 34 Glendale Road, Sharon, MA 02067 MAXIMUM BUILDING HEIGHT: 30 OR 2, 1/2 •STORfES ` 0 Engineering b SCALE DRAWN JOB. NO. I Fs£c/SA Engineering Works Inc.LOOD PLAIN DATA "=30' P.T.M. 164-09 7/lb �� 9 ld nc. FIRM PANEL #250001 0021 F (Rev. .7/2/92) < �' 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0. ZONE,:,,C„ -� y tFq '" (508). 477-5313 7/9�09 P.T.M. 1 Of 2 A` _ . i NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE <• EL:93.3 _ FOR.'A DISTANCE OF 15' AROUND THE PERIMETER OFLTHE S.A.S. .' (3) 5" DIA.OUTLETS SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. 1� 5,5" 16" �i 2" INSTALL RISERS & COVERS OVER INLET & a INSTALL WATERTIGHT RISER & 'INSTALL 'INSPECTION' PORT OVER END UNIT El T.O.F. OUTLET AND .SET TO 6" OF FINISH GRADE COVER SET TO, 6" OF GRADE EXISTING -. F.G. EL.=96.4f F.G. EL:-95.5t F.G. EL: 95.5t t 15. " 12" 6" 6"TAIN2% GRADE (MIN.) OVER,•S.A.S.'INS ECTION H-10 LOADING 2 L 19'; L`= 6'(MAX) PORT , t ® S=1% (MIN.) ® S=1% (MIN.) 1 4"SCH40 PVC 4"SCH40 PVC - x 10"I 6• ''11 3" TI D-BOX EXISTING - 48" LIQUID 14 INVERT LEVEL" , ','ADD INV.-93.27 PROPOSED INV =93.10 R GAS BAFFLE - 3 ROWS OF 7 UNITS AT 6.25'/UNIT INV.=93.93f D-BOX 2:94 - INV 9 EXISTING SEPTIC TANK EXISTING : ' SOIL- ABSORPTION SYSTEM (PROFILES k f. { ESTA LISH TATIVE COVER, BACKFBILL WITH CLEAN NATIVE OR s 75'- " PERC•SAND TO TOP OF'CHAMBERS ` BREAKOUT=TOP 'TOP ELEV.=93.33 FILTER FABRIC NOTES: INV. ELEV.=92.94 �, OVER UNITS .1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE . �', " BOTTOM' ELEV.=92.00 t i. ,. (RECOMMENDED)' INVERTS, PRIOR TO INSTALLATION. . s " 2.83' I 761 2) D-BOX SHALL BE SET 'LEVEL AND.TRUE TO 5' MIN. ABOVE BOTTOM -OFY, GRADE ON-A MECHANICALLY COMPACTED SIX` T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH=8.5' INCH CRUSH ED`STONE BASE, AS SPECIFIED IN'-`' EXISTING SUITABLE PROFIT »" 310 CMR 15.221(2): _ _ MATERIAL _ .- . „ ' -,ADJUSTED G.W":EL.=83.8 _ - _ 3) INSTALL INLET & OUTLET TEES AS' REQUIRED.' ' I r USE"3 ROWS OF 7-16"(H-20) ADS BIODUFUSER-UNITS 4) GAS BAFFLE TO •BE INSTALLED ON OUTLET TEE , SEPTIC `SYSTEM PROFILE , WITH NO SEPARATION BETWEEN EACH ROW.&:+NO STONE ` AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. -` e AL S r 4 . TYPICAL SECTION � 16" M.T.S. 11 2".� 1 rF r ' SOIL LOG 34" -I DESIGN CRITERIA -r SECTION `END CAP DATE: JULY •8, 2009 (REF.#, 12,627) t , . » � . SOIL, EVALUATOR: PETER MCENTEE PE, CSE SE#1542.) " NUMBER OF 'BEDROOMS: 4 BEDROOMS` 3 EXISTING + 1. PROPOSED) 16"" � IGH'tAPACIT'Y (H=20)' BIODIFFUSER'UNIT " - ( WITNESS:''- DAVID STANTON RS, CSE ' SOIL TEXTURAL CLASS: GLASS I DESIGN, PERCOLATION RATE: �<2'-MIN IN . '' EIeJ. TP. �• Depth Elev: T.P-2 ,Depth .Elev, TP'-3 Depth Elev. TP-4 Depth ♦ MODEL "16" HICAP s + sr / r DAILY' FLOW: '440 G.P.D. " ', 93.6 A ,. O'� •'93.6 A 0" 95.6 A 0" 95.5 A 0" • LENGTH 76',' NOTE: UNIT CONFIGURATION AND AVAILABILITY'SUBJECT DESIGN FLOW: 440 G.P.-D.' SANDY LOAM SANDY LOAM SANDY LOAM SANDY LOAM EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY . t•" 1OYR 4/2 1OYR'4/2 10YRe4/2 1OYR 4/2 DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE.' GARBAGE GRINDER:'"NO 93.1 6'' 93.1 6 95.1 6 95.0 `6" SIDE WALL HEIGHT 11.2" ° a LEACHING AREA REQUIRED: (440) = 594.6;S.F. B• e , B B OVERALL HEIGHT 16" SANDY,LOAM SANDY LOAM SANDY LOAM • r SANDY LOAM .74 �, • 4` 10YR 5%8 .10YR 5/8 ;10YR 5/8 1 OYR 5/8. OVERALL WIDTH 34" 4640 TRUEMAN.BLVD EXISTIN.G;_SEPTIC_TANK. 100 GALLON CAPACITY TO REMAIN 91.1 30" 91.4 26" 93.3, 28" 93.2 28" HILLIARD, OHIO 43026 _ P ( ) C PERC C C C 13.6 CF 30" _ CAPACITY 'PROPOSED D BOX: 1 INLET, 3 OUTLETS (MINIMUM), H-10 RATED 42'- . PERC (101.7 GAL) ADVANCED DPAJNAGE SYSTMS, INC. MED. SAND MED. SAND 42" 2.5Y 6/4 2.5Y 6/4 I PROPOSED SEPTIC SYSTEM. SITE PLAN . MED. SAND MED. SAND USE 3 ROWS 'OF-7 - 16" HIGH CAPACITY ADS BIODIFFUSER UNITS 2.5Y 6/4. 2.5Y 6/4 y�/ 'N0 STONE FOR AN S.A.S: WITH -DIMENSIONS 8.5' x 43.8' 83.8 ADJ. GW_ 11 83.8 ADJ. cw_ 67 , OAK STREET, COTUIT,• MA �; x�HIGH CAPACITY INFILTRATORS MAY .BE SUBSTITUTED '82.4 sic. cW= 134" 82•4 STc. GW 134" 134' MA 02067 ._ ) Prepared for: Patrick Minihan, 34 Glendale Road, Sharon, 82.3 135" 82.3 135 84.1 135" 84.0 .135 : SIDEWALL AREA:- NOT APPLICABLE Engineering by: SCALE DRAWN JOB. NO. PERC RATE' <2 MIN/IN..,("C" HORIZON) ' BOTTOM AREA: (GENERAL,USE APPROVAL FOR 4.7 SF/LF:OF BIODIFFUSER) PERC RATE <2 MIN/IN. ("C" HORIZON) NTS P.T.M. 164-09 21 UNITS x 6.25' LF x 4.7 SF LF = 616.9 SF INDEX WELL MIW-29 (ZONE A) Engineering Works, Inc. WATER LEVEL = 7.8' - JUNE 2009 NO GROUNDWATER OBSERVED 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. GW ADJUSTMENT.= 1.4; (508) 477-5313 DESIGN FLOW 'PROVIDED`. 0.74 GPD/SF x 616.9 SF .'= 4565. GPD 7/9/09 P.T.M. 2' Of 2 ' p F i1 1. - Alt-f-• - - - � _ -. ' ' . ' Z. O WINDOW AND EXTERIOR DOOR SCHEDULE] a$ a �p 8'-9 3/4' 8'-4 1/4' - I t KEY MANUFACTURER ITEM NUMBERe ".IV Ott 5ME ROUGH OT#NIT:G NOTES A 5EE OWNER FRONT OR w/5.L 5 RE-USE EXIST.DR./ADO NEW SIDELIGHi9 Z -? • W b \ B ANDERSEN 244On2836 9 DOUBLE HUNG 2'.8' . 4' 6- I 200 5ERIE5-TILT-WASH i I C ANDER5EN 244FX5049 1 PICTURE wD.v 200 SERIES-TTli-WASH J 4!� ANDER5EN .2440h2O49 2 DOUBLE HUNG 2' 0* . 4-9- I 200 SERIES TILT-WA5H O 1 La`T X CL f E ANOFRSEN I DOUBLE H;,NG 2'-O' O' MATCH EX15T On l MULL TOGETHER exist. Cj i11 m t existing 4' � '- F ANDf RSEN _ �244DH2030 2440n2849 - 3 'DOUBLE HUNG 2'-8' , 4-9' 200 SERrtE+ TnLwASn BEDROOM V. . (verily dlmenslonsl a NOTE: VERIFY AND MATCH EXI5TING KITCHEN WINDOWPRIOR TO ORDERING a new BEDROOM © ` CL INTERIOR DOOR SCt1EDULE a, !CL " O ' -- _ KEY MANUFACTURER SIZE I O1' Stt1E ROUGH OPENING I MATERIAL ,. - , , Nl - _ - • H A t I. � I dRO5C0 2' 6' 6' e` 1 L 6 PANEL 32' 83' I � W000 nBWId•cased Opening G` "6 PANEL DR VERIFY I P.f-USE EX15T.CLOSET DOOR a) �__-_ m I $ I cc I , "('• remove exist-door -O - existing 3 -• 6 PANEL FR.DR. VERIFY -I RE-VSE EXIST SIDE ENTRY DOOR new C ISt. BEDROOM - •4- - BR05C0 4'-0,. 6.8- 051 6 PANEL - 5C'< 83 %OOD �x\' I l:. I ' LOFT � m - edrydimensions) \ I I 11+{Y•(14'-3"X8'8' : 8' RN 6PANEL 32', 3' I WOOD® 5 dRO5C0 2' 6' G'- 8 future g new .._ R BATH I I' CLOS 't 1 > 6 2' 2'. G' 8" Rh 6 PANEL VERIFY RE U5E EX15T.BATH DOOR +,. A �s - • 1 . I 6`6"�•-8".i i cb 1 - • _ - - - - . - 6 1 3 7 BROSCO 2' 6' 6' B' POCKET DR - 14' WOOD . ' -------�Q I -- -I--Q--I- -1-- -_ 8 BROSCO 2'-6'. 6'-8- Rn CPANEE 3?'./B3' —01 - +++ ! - NOTE: VERIFY AND MATCH M5TING WOOD DOORS - NEW ADDITIONexistin ExLSiRdG•NOUSE - - - ) - WOOD t VERI-r IUTcnEN D DECK . _ .. PROPOSED 3'-I o u2'• EO 112' 3'-5' - CABINET LAYOUT - e I- - - , s, SECOND IFL OI O R PLAN CENTER\1DW ON SINK 03 (VERIFY DIM S., a - - 1/4"=l.-0. ... �� 430sQ.R-. _.�,v:.,; .: 'exist. a new�wdw .10 ' rn D 1 mulled exist. m i. cr S . - I expanded existing i f I KITCHEN existing FAMILY ROOM ' ne ® 7` relocate ' DINING (wood) STER pow derrm. B ROOM OO 16'10'X14'-6" relocated cab's- " I I .: DN a REF u carpe IVERIFyC:O) n (n GENERAL NOTES: W I. THIS PLAN HAS BEEN DESIGNED IN ACCORDANCE WITt j THE 7TH ADDITIO4,01!THE MASSACHUSETTS STATE BUILDING CODE FOR ZIO 0 ONE AND TWO-FAMILY DWELLINGS.AND THE MA55AC U5ET-5 m OO f, W h W CHECKL15T I`OR COMPLIANCE FOR WOOD FRAME, - s X er 6 c CONSTRUCTION IN A 1 10 MPH EXPOSURE S WIND ZONE. . O = g 2'-7 i/ • existing Q ENTRY LIVING ROOM A Aa 2. THE FRAMING CONTRACTOR MUST REFER 70 TNE'TAB 5 AND m 2 new new woad) Icorpefl U � / Z FIGURES WHIM THE WFGM I 10 MPH IXPOSURE B GUIDE FOR a © MBATH ® o PWD UP ( t ILLUSTRATIONS AND REQUIREMENTS SPECIFIED ON THIS PLAN. in file . O file I I [E-=,-) remove 3. ALL CONNECTIONS AND NAILING MUST MEET THE cbs. ® po REQUIREMENTS OF THE GUIDE IN ORDER TO 13E IN O 0 _ Q v Z WITH THE MA55 BUILDING CODE. - -- ----- --- -I- -- --- - - ------ - ----- -- 1T ERHANG ABOVE 2'-3• 5'-a'I+i-, �2'-3" 12-OVERHANG ABOVE 4. THE CONTRACTOR 15 RESPONSIBLE TO INSURE THAT ALL 1 ;1 exis step C �• 0 CONNECTIONS,NAILING AND ANCHOR BOLTS ARE V151BLE TO - I expanded landing(both sides) , 13 '` �wf 0 THE.IN5PECTOR AT THE TIME OF FOUNDATION AND FRAMING 6'-3• T-ID' 3'-I' line of exist.step _- 'INSPECTIONS. _6. 6- � O � 5. THE CONTRACTOR MUST REFERENCE THE 51MP50N STRONG TIE I 5 5 W Iii C-2005 CATALOGUE FOR ALL STRAP,HANGER•AND TIE T-2' 28'-0 - I K. INSTALLATION REQUIREMENTS AND UMITA110N5. - - .. NEW ADDITION EXISTING HOUSE DATE: 03l24/DB • _ ' PROPOSED .. .. Iy FIRST - FLOOR PLAN scALE: v4_,•o 1!4'_1.�., -. 412 sq.tt. DRAWING f!: total- 842sq.h. .. .. - . TOrA.? 3 ;:..-y .4k.:t• T..i�.r-� -_- .1. ' :: '�.+' t 'T:, f: ',t r:`- � :F_ -„4... Yam•` - r - _ • • , p o Q s Z CON7IN0005 ROOF RIDGE VENT - _ Z WHITE CEDAR SIDING 'ROOF 5HINGLE5 TO MATCH EX15T. - t TO MATCH ENISTING RAKE TRIM TO MATCH EXI5TWG 2 _ _ —---_- _soFFrraus�� sd' -- .I - TO P;, fX1171NG - - r EnmG nr u - 71LT WASH 2005ERIF5 MUR NEW ENTRY ROOF' 3 TO MATCH EX1 -ANDCOLUMNS -- - t�S _ 2rRl F10pt r . ...• .: C19NIG Ert _- -- r_ CEILIrIG M In . ' - - - _ i , IALK l WITHE ST.1 — FFQ B 1.615 PIN£... - — 'llTllTII�JJ� _ Nil _D05TING S7EP5 is CORNER 505. B 8 W/NEW RAIUNf>,: - 3 --- - — ''v . ff -- .. 3'FIRST�ooR 1� _:- -- I _T — FRW FIOCR +. '3'-0•. - p. CLAPBOARD 510ING - _ L EXPANDED . - TO MATCH E%LST- EX15TING BRICK 5TEP l WHITE^CEDAR SIDING - - STING 17.2' - TO MATCH"STING lA G 01 T' 28 (EXPAND DING WIDTH ONLY) NEW ADDITION ,: EXISTING HOU5E - - - • _ - - - BROSCO FRONT 4 PANEL DOOR WITH 14'51DELIGNTS ' - AND 1.4 PINE CA51NG AROUND 4 BT1VN. PROPOSED - ,- PROPOSED - LEFT SIDE ELEVATION _ FRONT ELEVATION ol ul N 1 -_ - CONTINUOUS ROOF RIDGE VENT ROOF 5HINGLE5 TO MATCH EX15T. . T I GENERAL NOTES: — - - — - . %L .ITE CEDAR 5HMGLcS - —._- _— -F.. —_ — TO MATCH EY15TING 3 - ® .... I. THIS PLAN HAS BEEN DESIGNED IN ACCORDANCE Wn ..THE 7TH .- _ - .__---- _- -- - --- -..--_-- ---:. 1' .'.' - - ADDITION OF THE MA55ACHUSETTS STATE BUILDING ODE FOR F ` -ONE AND TWO FAMILY DWELLINGS,AND THE MASSAC USETTS ,w.' - _ — --- --- - _ - CHECKLIST FOR COMPLIANCE FOR WOOD FRAME - _ _-- - -- - I -:- _---T — 2nn ROM CONSTRUCTION IN A 1 10 MPH F�CP05UREB WIND ZO(�E. -_ _- -- ----'— '---- .-. -. .. j t'r'— - - 1 - --- _-_—_____.—_ _-_._--_ ._ - - ._ 1 C�uulG nT - - O . 2-. THE FRAMING CONTRACTOR MUST REFER TO THE TAB SAND - - ® ® - FIGURES WITHIIN THE WFCM I 10 MPH EXPOSURE B G 1DE FOR -- - -— — — - -- aGn.hTn Is•lncr L ILLUSTRATIONS AND REQUIREMENTS 5PECIEIED ON THI5 PLAN. LL • 3 ALL'CONNECTION5 AND NAILING MUST MEET THE _ - - ---- - REQUIREMENTS OF THE GUIDE IN ORDER TO BE IN COMPLIANCE -- `. WITH THE MASS BUILDING CODE. ;' -- R - - — Q''u ElRsr noac ._ -.._- '--- _ --- - - - - --- - -- -- HP,pr nave _ I. � O 4. THE CONTRACTOR 15 RESPONSIBLE TO IN THAT ALL EnsnNG DEoc — - 1 i I' T _. < ' CONNECTIONS,NAILING AND ANCHOR BOLTS ARE VI5113LE TO 1•" 1 I' THE INSPECTOR AT THE TIME OF FOUNDATION AND FRAMING v G W . ,INSPECTIONS. - - - / m • OJE EXI5ITIIG SnOv,fR +£w:J.+.R U+B<Y W } - NO MARC ROOM IOR 5. THE CONTRACTOR MUST REFERENCE THE 51MP50N STRONG TIE LwMTC ENMNDO.•, C-200i5 CATALOGUE FOR ALL STRAP,HANGER,AND TIE 2 w INSTALLATION REOUIREMENT5 AND LIMITATIONS. - NEW ADDITION O H". PROPOSED -REAR: Er L E V A T 10 Na� ' Ii4 =p-0 sCal e: 1N"=r o �<.. �F [ rYacauR cc cornrl vccF 11nc,.eni - X. L• - - 3 1 O'1 3'5' '- 2• 1 O r/2' 2,Br ROOf PAFTCk5 @ 16'O c - . W z•cox ft--.1NL. RL�P SHr j-i0"Tcn LvrSl I r-Op Ls 10 Irz exist. I ho - _ w! n Is c. rn:G zc cPruNe u051, q ru,c y nwel ' Cwnn=Orris YEJa n: , __yGR- - I,- ,2020 AJ,c[ [N BASB.1[NI •aOOP O✓CR u:G V 1 t- av cu unurr wN, T>,lcu F ,Q:•. t 1 , Ala n NEw BEDROOM BATH T H ANCL>`w..on,wa+' (. ¢� Qu FULL B A S E M�E N T - z:e vqr Ru'rrxs Cs'1e•o.e' ,z _r - 4 -��+Bnea a 9cMu rav I ACCESS n 4v W4.1.e nw.•000 BFLooR ovfR Saco eLrxwrc- - " - f Nce BARW[R OP[R CIfAx I I, EW ING i.. . DBL 2.0 rLCYM Jg9TS 16'O C rrD rL(Ya v • '4 c001ARC0 GRANULAR 80.5[ 3B N FRILL BASEMENT ' ". IulGn w.1P IX511 1 T : v.D,wGF I a • ' r• I I O r F". .' • - UP _ fJOSnNG G/Rt AND cQU • , I ' - i I M. BATH _ 5,4, 5.6. 5.6. ur.'S n`,DRs[^nnuRf wow - _ zaosfur / 1 1 BEDROOM MASTER ' IcLr 2,6[Xi¢i S1W 0.J3 KFS Nam' -II 5ra-20 [LOCK J15 @ r6'O.0 • n •' I ,,?.vl L./J (CM . ' rJL FCGL IN5II w /1-COJf R1w'O. 05 - _ f,CiR -i �:a- � w • ' ' nWSF wRPP ,.c 9nYWrFS@ ' • - 5' - 9n.Wnr9vzclm ialau c"T G'FBGI 1.5Ul • , I • I O - 3 12-DIAMR[R Sl�i WyVLC}UMN9 -- I _ _ p - _ I _ - � � Q13gY30'Y rOCwC M11RL --- � I f FOp11NG TWIGI eau MTh :r L! FULL i uoiniI coc - 3l3 •PUN(WISnpCS _ 5¢ u4+cumfF«LVAo,c. 1` I BASEMENT - z wfuo hares I B-,nrct.-�nLn cuvfo - - - �'fr.rOFDIJOrt, � Cq,CR(TL FOUr.Otl o+Wut 1 r. G N rn,4.LIA . I ' ... q,B'.r F'Cgrirr rOO1wL '�'• I � � _ ..@Ij•O.C.VRRTNJ,LLY p/IN.99[25/ - 1' •-1 cONCRfI[CO4tPAc1[S1FB ... q,¢[AN. D. - ' I LRW,uLAR BASF - - •. - micr,Fgafo .c rgmaeira, . ., B-mwRnx,Rm coNCR�r L .. wALf weuccar uou•.cwc. 194 -- -------I--� uw[R u[W m,cx[,c BL' IANorw Y,;. voonNG-Auw m[wsnrw 1 et vfe. re m Ir4- -0 3/a _ - Fouuo.nw L • -_ __ el 1}Eyp./1ppRION. a,y d. - i EXMINGHOUSEsl S1 SECTION AT MASTER BR/;BATH ,_ .. • i - - h PROPOSED ` FQUNDATIO � PLAN ' _ 1 r - ` - - EXTERIOR WALL CONSTRUCTION NOTES: - - YGEN_FRAL NOTES: .. - ._ - - - FLOOR CONSTRUCTION NOTES: I. THIS PINd HAS BEEN DESIGNED IN ACCORDANCE WITH THE 7TH -I, ALL EXTERIOR WALL STUDS SHALL BE 2xC @ IG"O_C. _ I. FIR$T+TWO JCNST BAYS ON FAGtI FLDQR SHALL BE BLOCKED • - ADDITION OF THE MASSACHUSETTS STATE BUILDING CODE FOR - - - - - - - •+ WITH ZX LUMBER 5PACED'AT'48`I5-C FOR THE LENGTH`OF THE-1015T- - - 2. DOUBLE TOP PLATES ON ALL EXTERIOR WALLS SHALL HAVE - ONE AND TWO FAMILY DWELLINGS;AND THE MASSACHUSETTS _ -. - - CHECKU5T FOR CC MPUANCE FOR WOOD FRAME ACCORDANCE DANCESPLICE OF 4'AND NAILED WITH(7) I Gd NAILS IN, - s ` ACCORDANCE WITH TABLE G IN THE WFCM 1 I OB BOOKLET. .• - 2. SHEATHING TOZE'NARED IN A WfTH TABLE., - .; _ yY3 ' CONSTRUCTIQN IN A f 10 MP('t FUlP05t1RE B WIND ZONE. n 2;G@NERAC NAILING SCHET)UIP 1 1'0 MPFt EXPOSURE B `= !li'o z -- 2. THUFRAMING CONTRACTOR MUST REFER TO THE TABLES AND IN ALL ) 1 _ 5 _ 1 ._ r .g' 'WIND ZONE.Bd NAILS;6'SPACdt1G A EDGE AND 2-SPACING . - r FIGURES WLTHIM THE WFCM t 10 MPH EXPOSURE B GUIDE FOR ESTUD. - _ L PLATE TO STUD NAILING SMALL BE(2 I Gel NAILS ACM -t AT FIELD ILLUSTTtATION5 AtiD R.QL)IREMENT5 SPECIFIED ON THIS PLAN. ''� Y s - 4. BOTTOM PLATE TO FLOOR BOX NAILING SHALL BE(4)I Gd 3. ALL COMIECT)ON5 AND NAIUNG MUST'MEET THE. .3... - NAILS.PER FOOT. ' ,• •, i . R„FOtf3R-FAAEMS&'TttE GUIDE IN ORDER TO BE IN COMPLIANCE .1 - OOF CQN5TRUC ION NOTESc 5. _USE(2)KING STUD5 FOR OPENINGS UP 4'WIDE,.AND . .- ... mr SHE KfA59 BUILDING CODE: - aSTUDS FOR OPENING5.5'TO 9'WIDE. R � [ I. RAFTER C G'T►ON TO TOF PLATE& E SIMPSON it-I O OR ' -._4.' SITE C00fFRACTOR 15 RESPON51BLE TO INSURE THAT ALL 6 '• H 14 NURRIGAI,Ils CLIPS AT EACH N-25 CUPS CAN BE - CC2+RfEGTPCRlS;NAIfJN6 AND ANCHOR BOLTS ARE VISIBLE TO m FOR SHEAR AND UPLIFT CONNECTION Of D(TERIOR'WALL USED AS ASI�BSTIT _ ~ 1•'� 3' �: VTF IF BLOCd:I INSTALLED AT EACH TIE P45PIE AT TN€1`FME OF FOUNDATION AND FRAMING T EDGES A C IN FIELD. NAILS SPACED G' "RAFTER BAY Ai?J1E PLATE TO RESIST SHEAR AND LATERAL .:. SHEATHING,U5E.5d'OR;EOUIVILANT GUN O.G. A NDi12'O. i � r f iICSPE.'-ROec9. ; .. LQAD9=�Aji-'C iP6.70BF INSTALIfD NACCORDANCB:y�Ttl ,. MANUFi>rTURER REQUIREMENTS. T 7. EXTERIOR WALL SHEATHING SHALL BE 112•COX PLYWOOD 1- 5- Tiz COk"L LTACT MU.5T REFEREt:CE THE SIMPSON STRONG TIE •'"AND INSTALLED USING FULL SHEETS RUNNING FROM THE -C-2006 CATAWGL-Z fiOR ALL STRAP.HANGER.AND TIE - - - - * 2. IN jAli'G,LLAR TWS WTTHIN UPPE IRD&'ROOF HEIGHT AT P.T.SILL PLATE AT THE FOUNDATION UP TO 27 MIN.INTO it !t ,rt'iATCC?N'REQ(A1ME NTS ANDLIMRATIONS. - - €AH'P.ArTER' '-/ F.�rF ••1 I - THE SECOND FLOOR BOX. THIS SNEATHINGiNSTALLATION •.: r .. - . - METHOD:15IN ACCORDANCE WITH THE MASS CHECKU5T -' �3-. ROOF SHEATHING 5HAt;L9rf")12'CDXArACOD.AND INSTAUPD - ` ' .•-z FOR COMPLIANCE AND EUMINATES THE NEED FOR STIFEL t-,.t'cv '` •'- '" USING BdNAILS®G.OrC.-ATE 'ANt3.F2'O.C.INYIELD. - 5TRAP TIE5 AND HOLD DOWNS. j+PJ, m iF i• :s. t ,,�. ,.i,l. ,ram':x. .;.Y�:t�`--: .l` .4 •(. Qom.e.�-:... .•. .-..... .. �). ... r `1• 2..._ .,}.'.....1.J�. r G. .: tYT-.N f` ��:: :�r J }, .-C• .:(V. �� .1;r . .. ... -. •._ .. '. . ': .'...- .:: :`I.2r. Z•,r:r.U.•r`:A..r.E::a_ 'J> r.�.-' ��.5'lI�• JX. u')�ICYt?